肝细胞癌患者血浆骨桥蛋白表达水平与术后复发及预后的关系  

Relationship between Plasma Osteopontin in Hepatocellular Carcinoma and Postoperative Recurrence and Prognosis

作　　者：张辉[1] 应敏刚[1] 任宁[2] 叶青海[2] 汤钊猷[2] 钦伦秀[2] 

机构地区：[1]福建省肿瘤医院腹部外科,福建福州350014 [2]复旦大学附属肝癌研究所复旦大学附属中山医院,上海200032

出　　处：《中国临床医学》2007年第1期1-6,共6页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金重点项目(30371378);国家杰出青年基金(3032504)

摘　　要：目的:分析肝细胞癌(HCC)患者血浆骨桥蛋白(osteopontin,OPN)表达水平和术后转移复发及生存预后之间的关系,评价OPN在预测肝癌术后复发及预后中的作用。方法:应用酶联免疫吸附(ELISA)法测定101例HCC患者的血浆OPN表达水平,统计分析血浆OPN表达水平和临床病理指标以及生存预后的关系。结果:101例HCC患者外周血中均有OPN表达,中位水平为176．90μg·L^(-1)(13．73μg·L^(-1)～780．00μg·L^(-1)),平均水平为(218．94±149．18)μg·L^(-1),血浆OPN水平和肿瘤数目(P=0．002)、分化(Edmondson分级)(P=0．015)以及TNM分期(P=0．016)有关。有术后复发的患者比无复发患者血浆OPN表达明显增高(213．55μg·L^(-1)和153．70μg·L^(-1),P=0．0013)。OPN低表达组患者(≤200μg·L^(-1))的总生存(OS)时间和无瘤生存(DFS)时间均明显高于OPN高表达组(＞200μg·L^(-1))(P=0．0001),OPN低表达组患者的OS和DFS时间分别为774d和571d;而OPN高表达组患者的OS和DFS时间分别为635d和398d。应用COX回归模型进行单因素和多因素分析均表明血浆OPN浓度是影响肝癌患者生存预后的一个独立危险因素。结论:血浆OPN表达水平与肝细胞癌患者术后复发和生存预后密切相关,有望成为临床有用的一个预测指标。Objective：The aim of this study was to investigate the association of preoperative plasma OPN level with tumor recurrence and prognosis of patients after resection of hepatocellular carcinomar （HCC）. Methods：A total of 101 patients received liver resection for HCC from August 2001 to December 2001 in Liver Cancer Institute of Zhongshan Hospital, Fudan University were enrolled in this study. The preoperative plasma OPN levels of these 101 patients were measured by ELISA, and the results of 6 patients were validated by Westem blot. The association of the plasma OPN level with the clinicopathological characteristics [including age, gender, the history of hepatitis, degree of liver cirrhosis, liver function, Hepatitis B virus surface antigen in serum （HBsAg）, α-fetalprotein （AFP）, tumor size, tumor number, vascular invasion involving a major branch of the portal or hepatic vein（s）, tumor differentiation, resection margin, and blood loss, tumor recurrence, overall （OS） and disease-free survival （DFS） of patients were analyzed. Results： OPN could be detected in all of plasma samples of the tested patients with a median level of 176.90 （interquartile range [IQR] 142.42-248.78）μg·L^-1 and a range of 13.73-780.00μg·L^-1. The median plasma OPN levels were significant different between the patients with single and multiple tumor nodules （168. 18 [IQR 121.50-212. 23] vs. 217. 11 [160. 83-379. 06]μg·L^-1 ; P = 0. 002）, the patients with different Edmondsorfs grades of HCC （201.24 [IQR 143.01-275.46], 168.36 [132. 24-216.07] and 503.58 [161.31- 654.07]μg·L^-1 for grade Ⅰ, Ⅱ, and Ⅲ or Ⅳ, respectively; P = 0. 015）, and those with different TNM stages （168. 16 [IQR 119. 30-211.90], 167.54 [145.40-215.95], and 216.18 [157. 82-393.42] ng/ml for stage I, II, and III or IV, respectively; P = 0. 016）. A significantly higher OPN level was found in plasma of patients who were found to have HCC recurrence during the followup compared with those without recurrence （213. 55 [

关 键 词：肝细胞癌 血浆 骨桥蛋白 复发 预后 

分 类 号：R735.7[医药卫生—肿瘤]